Are Gwyneth Paltrow and Goop winning against skeptics?

One of the problems we as skeptics and advocates for science-based medicine face is that quackery and pseudoscience are legion. They are everywhere. Worse, in many cases, they can be a good business model. For example, back when Oprah Winfrey was peddling The Secret, the magical mystical belief that if you only want something badly enough, the universe will somehow provide it, and promoting Jenny McCarthy’s antivaccine beliefs, skeptics were all over her. Many were the refutations of the nonsense that she promoted published in a wide variety of blogs, websites, and magazines; yet her brand wasn’t based on what skeptics thought. Criticism had little effect. Her brand was selling a fluffy, gauzy, “positive” attitude and lifestyle, and when she ended her long-running show it was on her terms, not because she was driven from the air by low ratings. A more recent example was, unsurprisingly, spawned by Oprah. I’m referring, of course, to “America’s Doctor” (whom I like to refer to as “America’s Quack“), Dr. Mehmet Oz. Many are the times I and others have documented the rank quackery and fear mongering he’s promoted on his show, be it homeopathy or the lie that carrying a cell phone in the bra causes breast cancer. Oz was even dragged before a Senate committee and humiliated, not having realized that he was a major target. It all seems to have had little effect on his brand. Indeed, when a group of physicians associated with an industry-aligned “science” group attacked Oz, it backfired miserably. Dr. Oz’s show is still around, still a “strong performer,” and was recently renewed through the 2018-2019 season.
Such were the thoughts roiling through my brain as I came across an article by Julia Belluz entitled Is Gwyneth Paltrow’s pseudoscience winning? Writing in the aftermath of recent incident in which the editors of Gwyneth Paltrow’s goop, that wretched hive of scum and quackery catering to affluent, woo-prone women by selling them jade eggs to stuff up their vaginas, magic energy stickers for health, and, of course, homeopathy and the usual assortment of alternative medicine, counterattacked against skeptics criticizing it by singling out one of its most persistent and vocal critics, Dr. Jen Gunter, Belluz wonders if skeptics are having any effect:

As the Goop website has emerged as a reliably laughable source of pseudoscience, a small army of journalists (myself included), doctors, researchers, and bloggers has evolved to pounce on Goop’s claptrap as soon as it’s out. We explain why jade eggs for vaginas, $30 sex “dust,” and body stickers that “promote healing” are misleading drivel. In the best cases, we use Goop’s bunk to teach people about how actual science works. It’s practically a parasitic relationship.

Recently, though, I’ve been asking myself what impact all this debunking is having.

Noting that she’s been criticizing Goop and Paltrow since 2013 and rattling off a list of examples of her work and that of others deconstructing the rank quackery peddled by goop on a daily basis, Belluz notes:

In the time we’ve been debunking Paltrow, the stories and books pointing out the absurdity and potential harms of Goop’s claims have certainly been read and bought. And it’s clear they resonate with certain readers.

But the Goop empire has also grown and expanded in influence. So I set about to understand why — and what impact, if any, critics have had on the brand.

She then notes that, despite the debunking Goop appears than ever. Even though it’s not a public company, which means that we don’t know how much money it’s making, Belluz notes that Goop raised $15 to $20 million in venture capital last year. Of course, compared to the Oprah and Oz juggernauts, that’s not particularly impressive, but it’s definitely nothing to sneeze at, either. Just last month, Paltrow held the first inaugural Goop Summit, which garnered extensive news coverage, some good to neutral, some mocking, but, as they say, any publicity is good publicity. One thing the publicity did reveal is just how much about the money Paltrow is:

This is Paltrow’s peculiar gift — or grift — and it was on full display at “In Goop Health,” her day-long event meant to bring her website’s “most requested and shared wellness content to life.” By last week, all 500 tickets, ranging from $500 to $1,500, had sold out; another event is planned for New York City in January.

Attendees were told via email to arrive at 9 a.m. The summit wouldn’t actually begin for another hour, which allowed enough time to shop inside a cavernous industrial space for Goop-branded products such as water bottles ($35), hoodies ($100) and a “G.”-branded flight pack consisting of four thin nesting canvas bags containing some magnesium packets, a sleep mask, earbuds and moisturizer ($198).

It was the physical manifestation of the day to come: For those willing to spend so much on so little, Paltrow will happily take your money.

The conference itself, of course, was chock full of every quackery imaginable, all peddled by celebrities and celebrity doctors. The dubious health modalities ranged from “leech facials” to aura photographs—”Holy quackery, Batman! Kirlian photography!”—to IV drips to earthing to crystal therapy (of course!) to the lectin avoidance diet, which was touted by Dr. Steve Gundry in his counterattack against Dr. Gunter. Indeed, going back to read about it now, I can’t believe that I only started to pay real attention to Goop within the last month. It’s been around since 2008, and Paltrow’s company’s been peddling utter nonsense a long time. I have a lot of catching up to do.

On the other hand, Belluz makes a good point. When I noted that the article by Dr. Steve Gundry and Dr. Aviva Romm was represented as being the first in a series of articles responding to Goop critics, my first reaction was, “Bring it!” It still is. However, my first enthusiastic reaction is now tempered by this realization:

Harvard Business School brand analyst Jill Avery told me this response may have been a calculated move to strengthen their brand and draw their customers closer. “The segment of consumers who engage with Goop are interested in alternative, homeopathic remedies,” Avery said. “So, when Dr. Gunter challenges Goop, she challenges the ideological foundation of its consumers as well.”

What’s more, Avery said, the Goop response evokes “themes from feminism, Eastern medicines and philosophies, and anti-establishment politics to incite [Paltrow’s] consumers to action: to make them feel as if they are under attack, to reassure them that their ideology will be supported by Goop, and to arm them with arguments to help them defend themselves.”

I also posed this question to Larry Light, author of Six Rules for Brand Revitalization and the chief executive of the brand consulting company Arcature. “You can’t attack a belief with facts,” he said. He agreed the Goop debunking would only galvanize its fans and thought that Paltrow’s new summits and magazine would further expand the Goop cult and deepen its members’ beliefs.

This is, of course, always the danger whenever skeptics go after a cult-like group like Goop acolytes. I also suspect that all the negative press last month mocking the Goop Wellness Summit struck a nerve, leading to this counterattack. Given the timing (not long after a whole lot of negative press about credulous, wealthy women spending ridiculous sums of money to imbibe the quackery being promoted by Goop and buy lots of Goop product), it’s also quite possible, likely even, that this attack on Dr. Gunter was an intentional business strategy to do exactly what is described above: Rally Goop’s fans and provide them with enemies who can be caricatured and attacked. Dr. Jen was a convenient first target because she fought fire with fire. When Paltrow attacked her critics by saying “If you want to fuck with me, bring your A game,” Gunter fired back by saying Dear Gwyneth Paltrow we’re not f**king with you we’re correcting you, XOXO Science. Yet, Goop used her use of the F-word as an excuse to paint her as somehow uncouth and crude compared to its “respected” doctors. Indeed, Dr. Gundry’s simultaneously pearl-clutching, mansplaining misogyny was indeed something to behold.

It wouldn’t surprise me if the next subject of Goop’s attacks is Tim Caulfield, who’s even written a book criticizing Gwyneth Paltrow and Goop. Then I could easily see Julia Belluz and other frequent critics of Goop finding their way onto the list of people attacked in regular counterattacks. The reason they weren’t first on the list is because Jen’s use of the F-bomb gave the editors an opening that the other targets didn’t provide. Never mind that it was only in response to Goop’s Dear Leader’s firing first. Indeed, Paltrow herself is a canny businesswoman who knows that there’s no such thing as bad publicity:

But really, the fact that Goop has survived – and is seemingly thriving – despite the endless mockery is because Paltrow, as a former darling of Hollywood, is all too aware of the power of the press. As she told Linkedin, “When you have an e-commerce business, no press is bad press”. Even in 2013 the scorn was beginning to fade, as Bloomberg’s Joel Stein admitted: “after a while you stop laughing at those $935 leather-and-gunmetal pants from Rag & Bone—instead, you want to own them”.

So does this mean that skeptics are wasting their time deconstructing Goop’s quackery? It’s not as though the website slowed down after this little dustup. It’s still peddling homeopathy and writing about how to “detoxify” yourself from “hidden mold.” There’s little reason to suspect that Goop will stop. Like many quacks, it’s basically immune to criticism. That doesn’t mean criticism isn’t worthwhile.

Belluz rightly points out that we “need to think about how to prevent Goopshit from taking off.” We do. We definitely do. She points out that we need to teach people how to think critically from a very early age. However, that’s not to say that “debunking” is worthless. If I thought that, I wouldn’t do it.

Think of it this way; liken it to the antivaccine movement. Goop basically peddles misinformation and nonsense on par with the pseudoscience and misinformation peddled by antivaxers. When I debunk antivaxers, I realize that I’m not going to change the minds of hardcore antivaxers. They’re too far down the rabbithole, and it’s incredibly hard to change the mind of a person like that. In fact, it’s damned near impossible. They have to be predisposed by other things in their life to change their mind before deconstructions of their beliefs might have an effect. No, I aim my efforts at those who might be on the fence, who might be susceptible to the pseudoscience of the antivaccine movement but are reachable in such a way that good information, entertainingly (I hope) presented, has a chance of beating back the bad.

It’s the same with Goop. I don’t expect to change a Goop editor’s mind. I don’t expect to change Gwyneth Paltrow’s mind in the unlikely event she were ever to read one of my posts. I don’t expect to change Dr. Gundry’s or Dr. Romm’s mind. I don’t expect to change the mind of someone buried deep into the Goop lifestyle. However, there are a lot of women who might see the rhetoric of female “empowerment,” coupled with the star power of Paltrow and her minions, and not have the background knowledge to know why what she’s peddling is bullshit. Skeptics can provide the knowledge, facts, and science to help them evaluate the products Goop sells. There’s value to that. There’s power to that. In fact, that’s real empowerment.

I know this can never be proven, but I do think that this debunking is having an effect. I think quacks who rose to extreme heights- like Dr. Oz- got a pass until it was too late. Same thing with Food Babe. Their imitators won’t be impoverished, but if skeptics keep doing their job, their success will have a ceiling it previously did not. Also, teaching the public to recognize these frauds takes time. The “psychic hotlines” that scammed people in the 1980s and 1990s seem to have vanished and earn the scorn and derision of most today. Other quack fads have come and gone. Hopefully we’ll look back at goop 20 years from now like we now look at Miss Cleo.

Orac: It’s been around since 2008, and Paltrow’s company’s been peddling utter nonsense from the very beginning. I have a lot of catching up to do.

Maybe not that much. As I understand it, up until her divorce from that guy from Coldplay, Paltrow was mostly running it as a side gig, basically a supersized version of an Etsy shop of some corporate CEO’s wife. It wasn’t until after the divorce (2014 or so) that she really doubled down on it.

@2: The Psychic Readers Network (the one Miss Cleo worked for) wasn’t shut down because of debunkers, though; it was shut down by an FTC lawsuit for deceptive advertising, billing, and collection practices. Deceptive advertising not for the psychic claims, but for misrepresenting the cost of the service. And it was the organization that did most all of the TV advertising. Phone psychics didn’t go away because of debunking, they went away because of illegal business practices.

As a high school science teacher I sadly must agree that sCAM is winning. When a town of 11K has almost as many chiropractors as family doctors, then sCAM is winning. When I hear colleagues who are sick or injured say “I went to my chiropractor…”, then sCAM is winning. When I see students covered like mummies in kinesiotape, then sCAM is winning. When the busiest store in your mall is GNC, then sCAM is winning. Skepticism is hard an offers no easy answers – that is a difficult sell many people (a hard pill to swallow if you will).

No, I aim my efforts at those who might be on the fence, who might be susceptible to the pseudoscience of the antivaccine movement but are reachable in such a way that good information, entertainingly (I hope) presented, has a chance of beating back the bad.

That you do, Orac, in a way that I admire and appreciate so much. Thank you.

Belluz is out of her element in trying to parse the growth of Goop and the effect of critique. She winds up conflating the problem of any attack – ‘all publicity is good publicity’ – with the specific problems of a skeptic debunking – sober explications of scientific fact are weak persuasion to general audiences. She also over-rates her own potential influence. So Goop has continued to grow in the four years she’s been debunking it. Well, what did she expect? She’s just one voice, and she doesn’t have anything resembling Paltrow’s megaphone. Maybe Goop would have grown more without her efforts. And while she may have been dogging Goop since 2013, Goop has really only entered the pop culture stage as a subject of ridicule recently, with John Oliver’s takedown and “all the negative press last month mocking the Goop Wellness Summit.” Belluz should probably be taking a bow on behalf of the early-adopter Goop-critics, as if they hadn’t labored in their own limited channels, there probably wouldn’t have been anything to leak out into the more popular media streams, no place for the newer critics to get the quick concise background material they need.

There’s a big difference between factual debunking and mockery. Mockery will create a backlash, but if it’s done well (easier said than done) it can be deadly over time. If Goop becomes a stock punch-line for late night TV comics (somebody get Kimmel on this) let’s see how well it’s doing a year after that.

One fairly obvious problem is Belluz’s worry about the growth of Goop in general. She takes this as evidence of some broad increase in woo acceptance, but that’s not necessarily the case. Goop may well be just stealing market share from other Veblen-Good-slinging ‘lifestyle’ brands and other pseudoscience scams. And, for that matter, she may over-rate the role of the more woo-ey Goop products in the success and growth of the brand, compared to the role of what appear to be the core products displayed on the Goop website: Clothing, Shoes, Bags, Jewelry, Accessories, Fragrance, Skincare, Beauty…

Methinks even the wellness woo is more ‘lifestyle’ than dangerous alt-med. In that, I have to say I think Orac is way overboard in comparing Goop to antivax. Anti-vax is anti-science as religious zealotry, Goop is pseudoscience as fashion. Fashion is all essentially ‘bullshit’, which is to say it’s all about aesthetics over pragmatics. Of course, aesthetics aren’t really BS, they’re a pretty fundamental aspect of being human. But we don’t treat our aesthetic objects literally; their function is figurative. And the aesthetics of fashion are always more surface than substance, and most importantly, constantly in faddish flux. How different are Vagina Jade Eggs from Pet Rocks? If wearing Energy Healing Body Stickers is hip in 2017, it will probably be passe by 2018, and gauche by 2019. And if we understand Goop-woo as fashion, we may be somewhat reassured that a large part of it’s appeal are gratifications that have nothing to do with serious deviation from sensible medicine, in those senses that fashion is fundamentally un-serious, a game of “let’s pretend”, a form of having fun.

There’s a great used book store in Niantic, CT, near where I used to live that has a section in the front of the store labeled “Atheists, Skeptics and other killjoys”. The guy who wrote that was a friend of mine, so I knew it was double-edged irony, and appreciated the thought, acknowledging that I can indeed be a killjoy sometimes. For example, I f-ing hate ‘Star Wars’. Part of that is that (with the exception of TESB, and Rogue One) the movies are just cinematic pablum. But another part is that I think the whole mythos is ideologically insidious in the ways its anti-science and privileges magical thinking. But to attack ‘Star Wars’ is to attack fun, and that’s not without it’s problems. It’s hard to say where make-believe stops being just make-believe, and just where, how, and how much escapist “fun” bleeds over into more serious realities…

And if we understand Goop-woo as fashion, we may be somewhat reassured that a large part of it’s appeal are gratifications that have nothing to do with serious deviation from sensible medicine, in those senses that fashion is fundamentally un-serious, a game of “let’s pretend”, a form of having fun.

Perhaps, but Goop also promotes homeopathy, colon cleanses, fad diets that can be harmful, “detox” regimens (which can also be quite harmful), and bad health advice. It’s all a package. You can’t easily separate the “fashion woo” like “energy healing stickers” from the harmful quackery. Therein lies a major flaw in your analysis.

At any rate, goop isn’t only about fashion- it’s about woo. The fashion angle is accessible in other better ways and I doubt that people go to goop primarily for a fashion report- there are lots other of those, print and net.

People go to goop to emulate GP and her sister/ fellow travelers- clothes are part of the deal but the altie/ hippie/ cool gir/ knowitalll vibe is primary.
AND you can’t do that without woo ( which rhymes with woo)

Why women are susceptible to sh*t like GOOP.
Dear Dr. G,
With all due respect, I think you are trying to educate the wrong audience. It’s doctors that need to be educated.
As a women, my biggest pet peeve is the dismissive way doctors treat women’s health concerns. I can’t tell you how many times I’ve been in a group of women and one or another complains about some health issue and all the other women start saying, “it’s stress.” Women learn this language from their doctors. I can’t tell you how many doctors have dismissed my health concerns as stress. For some reason, as soon as I hit 30 and had some legitimate health concerns, doctors tried to convince me that I had suddenly become unable to handle the demands of my busy life. . And the older I got, the more condescending the doctors became..
In my mid 30s I developed a series of symptoms that clearly, obviously pointed to one diagnosis. I will list them and see if you can figure it out.
Symptoms: a little weight gain, fatigue, dry skin, hair loss. Every year, for 8 years I went to the doctor (different doctors too) and was diagnosed with “stress”. Finally at 42, I went to the doctor and complained I was falling asleep mid conversation at 6 pm every night., and this doctor sent me to an endocrinologist. Not surprisingly I have hypothyroidism.
I can’t tell you how many friends have come back from doctor’s appointments and like me, were told to work on their “stress”. Is it any wonder women look to magic for help?
And if you think I’m a doctoraholic, constantly complaining about mysterious illnesses, I go to the doctor once or twice a year and I take one daily medication.
I am also flabbergasted that doctors are so frequently upset at patients who are knowledgeable. When my husband was first sick, I went to his appointments. I was pretty convinced my husband had cancer-not because I’m negative or anxious, but because I’m smart and I know my husband.. My husband had unexplained weight loss, consistent side and back pain, early satiety, and severe sob. I didn’t suggest that my husband had cancer, but I asked his doctor for a CT scan and got “now, now dear, let’s not overreact,” He told me that my husband had, gerd, COPD, (he did a chest x-ray and ruled out lc haha), back strain, and high cholesterol. He sent him to a pulmonologist for the COPD and as a parting shot to me said, “I ordered a CT of his abdomen to make you happy,” The pulmonologist found the lung cancer on his abdominal CT (it had metastasized to his liver and spine). And I won’t even tell you the story about the time a doctor assumed I was ‘drug-seeking and interrogated me for using the word, “musculoskeletal”.
And although, I shouldn’t have to defend myself, unfortunately most people reading this will think I’m some brash, pushy, hysterical woman (in itself, so sad that that’s the assumption and sad that I have to make sure I behave within some weird social gender norms boundaries to deserve respect), I’m a boring mom, teacher, nice lady you meet at the park walking her big puffy dog.
I’m not really susceptible to woo, but a lot of my friends are and I get it.

Aura photography isn’t necessarily Kirlian photography, though it can be. Probably more common are “aura cameras” which take a normal photograph and superimpose upon it an out-of-focus image of colored LEDs. Which LEDs are turned on and how brightly is determined by software from input from a set of electrodes you place your hand on which measures electrical resistances between them.

@ 15 I guessed your ailment before you finished your sentence.
My “stress” turned out to be lumbar stenosis. A friend’s “stress” was discovered to be fibroid tumors. Still, when it’s all said and done, the only one to really blame for turning to the Woo, is oneself.

Could be that the better way to attack things like Goop would be to praise their business model, for example, “by peddling thrift store trinkets and penny a pound supplements for Park Avenue prices with a hefty helping of health “wisdom” straight out of a 1970s issue of the National Enquirer, Paltrow has shrewdly crafted a business empire out of the gullibility of her followers. Investors would be wise to get in on the ground floor of this modern day Rasputin.”

It seems the strength of qualification I intended by the “somewhat” before “reassured” didn’t cross the great Internet divide. My points are:
1) We don’t know how successful Goop is in promoting health woo like colon cleansing and other “detox” nonsense. Belluz assumes the popularity of Goop generally applies to those things equally as to all the other merchandise, and it well may not. That doesn’t mean Goop’s success isn’t a bad sign, just probably not as bad as Belluz seems to think.
2) There’s good reason to think that in the form of upscale life-style ‘fashion’ culture health woo will have a different sort of investment among those Goopers who get into it via that venue than health woo has within the ‘mainstream’ of Alt-Med (if you’ll excuse the oxymoron). We would expect the Goopers to be more likely to dabble superficially, and be less likely to stay with it over time. Again, that doesn’t make the Goop-woo not-a-problem – it might be a sort of ‘gateway’ to more ‘hardcore’ Alt-Med, for example – just “somewhat” less worrisome than other cultural frames for cleanses, detox, etc., etc.

But these dynamics always work both ways, so it’s also possible that women who might otherwise be drawn into a deeper, more serious woo will have their impulses in that direction satisfied and then burned-off by a more superficial and short lived infatuation with Goop’s faddish woo-lite.

I’m sure plenty of Goop customers do separate the “fashion woo” like “energy healing stickers” from the harmful quackery, just as others separate the clothes, jewelry, and dinnerware from all the woo.* But at the very least, I’d argue you can’t just assume the “fashion woo” inevitably connects to harmful quackery without evidence. Popularization and commodification always weaken and hollow out subcultures as they spread salable versions thereof. If you’re revolted by punk, alt-rock, and nu-metal, you hate Hot Topic for spreading those styles to otherwise innocent mallrats. If you’re a devoted fan of punk, alt-rock or nu-metal, you hate Hot Topic for shilling ersatz versions of your passions to tennybopper poser mallrats…
––––––
But, these are actually secondary points to what I set out to express in my earlier comment, which was that Belluz is being too pessimistic in feeling she’s losing some fight to Gwynneth Paltrow. I did get a bit sidetracked from that in the second half of the post. Maybe her voice is relatively weak, and Goop has continued to grow. But she’s not giving herself enough credit, and not looking at the big picture beyond Goop. Other voices are now picking up her critique, and some of those, like John Oliver, are far more skillful at presenting it effectively. These things take time, and while Goop may continue to grow for awhile, today’s critiques could be the peas-under-the-mattress that eventually make the whole wellness-woo wing of the operation crash. More importantly, Goop’s silliness and Paltrow’s precious pretentiousness might backfire and have negative consequences for woo as a whole.

So, basically, I’m saying that if Belluz (or anyone else) thinks Goop is a problem, they should keep criticizing it, not throw up their hands in defeat. Which is not to say they can’t improve their messaging: If factual debunking seems not to be working that may be because it just doesn’t work very well as either a lone or central persuasion strategy. So sure, self-reflection and self-critique are warranted when your tack seems not-to-work. But it’s better to check your confirmation biases about what you would find convincing and what sort of rhetoric you want to be effective, and step into the mocassins of your intended audience and figure out what will move them, realizing it’s always a long haul and a complicated bit of business one way or the other.
–––––––
For that matter, I can’t imagine that anything but a minority of folks who buy supplements from NN share Mike Adams’ lunatic perspectives. When I’m in central PA, I always buy a box of Miller’s pretzels. Miller’s is a small regional company, apparently run by a very religious clan, as there are proselytizing Bible verses printed in large type on the side of each box. I just disregard that BS, because I really like the pretzels.

I think there are a few things to take into consideration when thinking about goop’s success and the impact of skepticism.
The first is that Gwyneth Paltrow is a full-on A-list celebrity and movie star. She could be selling literally *anything* and people would buy it just because she is selling it. So that will overwhelm a lot of the pushback. There are probably people who buy her tote bags but laugh themselves sick at the energy stickers.

The other is like Orac said; we’re not going to reach (probably) the people buying the stickers, but we may convince the people buying the tote bag to not buy the detox tea.

And I’d like to share two stories to remind us that we can and do reach people who seem lost on the path to woo.
1) A nurse friend posted to FB a link about flu shots being worthless. In 5 minutes her dad (non-medical, non-scientist) had replied with a citation of why that link was wrong, and she changed her mind about getting her flu shot. Win!

2) A cousin is a yoga instructor and pretty hippie and conspiracy inclined. She posted to FB that microwaves are terrible (in a conversation about cooking for yourself) and were invented by Nazis (among other things). I gently pointed out the less judgmental errors (when microwave ovens were invented, how they work) and she changed her mind!

sadmar @13 and 23
You’ve hit the nail on the head with “lifestyle” woo. That is what all successful celebrities sell: their lifestyle. Buy my clothes/bags/jewelry/makeup/hair products, follow my (insane) diet, follow my (equally nuts) exercise plan, read my books, etc, and you’ll be just like me, thin and pretty and successful!

In the world of celebrity, is as it ever was.

The thing that is different about goop is that it has branched out from the standard celebrity woo – weight loss. The intersection of fashion, celebrity and potentially dangerous diets/ exercise plans/ cleanses/ serious woo is enough for a thousand doctoral theses and has been the source of many, many books. Lots of celebrities do this. What’s different about goop is that it’s moved into other areas of health, and that’s where more skeptics have come in.

On some level its surprising that it takes woo beyond weight loss to get skeptics to pay attention to the risks, given the very real dangers of some of those “cleanses”, but maybe those have become accepted, where magnesium for sepsis isn’t.

most people reading this will think I’m some brash, pushy, hysterical woman (in itself, so sad that that’s the assumption and sad that I have to make sure I behave within some weird social gender norms boundaries to deserve respect),

I may be fooling myself, but I like to think that Orac’s readers are several cuts above this.

None of you seem to get it. You don’t convince people out of woo with facts and logic. It’s all about persuasion. I’ve learned so much reading Scott Adams’s blog (the Dilbert cartoonist). In 2015, he predicted Trump would win the Republican nomination and then win the Presidency. Why? Because Trump is a master of the techniques of persuasion.

Hillary’s problem was she seemed to think it was all about facts and logic. That’s not why people vote for a candidate. They vote for a candidate because they want to. It’s an emotional decision. Once they make the emotional decision, they analyze all the facts and logic through that lens. That’s called cognitive bias. You accept the facts that fit with your emotional decision and reject the ones against it.

You want to convince somebody out of their favorite woo? Telling them they’re wrong, the science says you’re wrong, the people who sell the woo are frauds is the wrong approach. Fact-based and logic-based approaches are the least effective. Gwyneth Paltrow is Trump and you are Clinton. Loser!

Adams explains what does work. You don’t start by confronting them, but by agreeing with them on something. Let them know you’re on their side. You’re their friend. That’s called pacing. Then you gradually introduce new ideas. That’s called leading.

Orac is a really smart guy. He’s an MD and a surgeon at a major medical center. I’ll bet he’s never tried blue-green algae from Upper Klamath Lake in Oregon, but if he did I’m sure he’d really like it. He’d probably recommend it for all of his patients.

I’ll bet he’s never tried blue-green algae from Upper Klamath Lake in Oregon, but if he did I’m sure he’d really like it.

Quite.

During a heart attack, the muscle is still trying to pump. There’s carbon dioxide but no oxygen. We wondered if there were any way to use plant cells and put them next to heart cells to produce oxygen from the carbon dioxide.”

@palindrom
Thank you. Sadly my husband passed away two years ago after 20 quality months of living. I feel I owe something special to this blog. After his diagnosis, I faced constant judgement for encouraging my husband to do chemo. (One person actually asked why I would allow big pharma to poison my husband!) This article in particle gave me the courage/knowledge to stand up. Ihttp://respectfulinsolence.com/2009/05/20/chemotherapy-versus-death-from-cancer/
I now advocate as much as I can against the lung cancer stigma and for lung cancer research. (lung cancer kills more than the four most common cancers combined!)
@sadmar
I agree with you that with GOOP there’s an element to what you call ‘lifestyle woo” but disagree that it’s not dangerous. I live in so cal and I think anti-vaxxing is viewed as a lifestyle choice by some. It’s dangerous.
@Mark Thorson
I think that there’s an element of persuasion to any good grift, I would argue you need a receptive audience. Women who seek out help for legitimate health concerns (weight, anxiety, fatrigue, etc…) are routinely dismissed and told their illnesses are in their head. Chronic Fatigue Syndrome and Fibromyalgia are two examples I can think of off the top of my head that were first called made up illnesses. I can’t help but wonder how they’d be treated if they were more common in men. But I’ve also know women who were first told their allergies, heart attack, arthritis, heavy periods, acne, IBS, were initially ‘stress’. ( and obviously there are amazing doctors who respect and listen to women but I think we need more.) So as women, we learn not to bother the doctor with our trivial pain and common health problems-and that opens the door for the Dr. Oz’s and Gwenyth Paltrows of the world.

WHAT WE SAY: A study in the New England Journal of Medicine indicates this product is not merely ineffectual, it actually causes the condition it purports to treat. The FDA has issued a warning letter demanding destruction of all inventory within 30 days. Quackwatch reports company executives charged in the deaths of three people. Gwyneth Paltrow says “This is really great for my skin!”

Polly does hit on a real problem in health care, and its the reason why nurse practitioners are so well liked by the public.

It’s not that physicians can’t have good bedside manner . . . many do. But enough don’t, and worse have terrible bedside manner, that it taints everyone else in the profession. I have a male friend who is like this. He’s had a couple enounters with physicians that were just awful; the physicians didn’t listen and were dismissive of his concerns. So he thinks all physicians are that way by default.

We both shared an excellent physician who retired a few years ago. My friend referred to him as the unicorn. That doc had excellent bedside manner and listened to his patients. So he rarely got the diagnosis wrong, and if he did, it wasn’t because he dismissed the patient’s concerns. When you went to his office, you knew he’d liklely be late, but you also knew he’d take the time he needed to talk to you.

Physicians often block appointment times in 10 minute increments. They have to, to bring in enough money to keep the doors open. Nurse practitioners are often salaried. My peds preceptor, a PNP, blocked 20 minute appointments.

You can build a trusting relationship in 10 minutes, but you better have mad communication skills to do it.

I think you’re right about the most serious problem in lifestyle woo being the diets, and that this is just kind of accepted and normalized, and that’s a skeptic fault.

I have the feeling that the sort of woo unique so far to Goop is there because it’s unique so far to Goop, rather than because there’s a great demand for it, or large direct profit in it. That is, I expect it’s fundamentally a branding strategy, and there’s some appeal in the ‘holistic’ image that works even for the customers who don’t go in for the woo, and are just there for the clothes etc. This may seem counter-intuitive, but marketing often is. I won’t try to unpack it in detail here, but just suggest the woo operates figuratively for these customers, helping Paltrow position herself as something like Paltrow as renaissance woman who cares about the right things… There’s also something “upscale” about Goop’s take on “wellness” that distinguishes it from more plebian celebrity endorsed fad diets and such…

Dude, Trump is hardly a master of persuasion technique, especially the sort of standard approach to public speaking Adams appears to be proffering (establish common ground first, etc.). His appeal is complicated, and rooted in celebrity and the image of power, wealth and control. And HRC ran what was largely a one-note campaign that extremely emotion based – trying to get suburban moderate Republican women to cross-over and vote for her out of fear of Trump – in that, her messaging included a lot of what you call “leading”. it’s just that she was pitching the wrong emotion to the wrong audience.

Trump had as many ‘facts’ as HRC did, too. They were just all wrong/lies.

Good for you for sticking with real treatment in the face of such peer pressure.

Panacea @34 — The anecdotal evidence I hear from my nurse-practioner spouse suggests you’re right about nurse-practioners. I can’t imagine anyone could be more sensitive and respectful to patients than she is (and I hasten to add that she’s a very well-regarded clinician as well. You can be as sensitive and respectful as all get out, but if you don’t know your stuff it’s not going to do that much good.)

Polly does hit on a real problem in health care, and its the reason why nurse practitioners are so well liked by the public.

I much preferred the NP I saw at the agency I go to over the psychiatrist I see now through Skype (or some similar thing). She actually took the time to talk through everything and wasn’t dismissive, and unlike the shrinks I had had in the psych ward, she didn’t just throw a million prescriptions at the wall to see what would stick.

The last appointment I had with the psychiatrist was after I had the Celexa doubled (because I had been chronically suicidally depressed) and he was like “any better?” and I was like “no, not really,” and he was like, “well, let’s give it some time and I’ll see you in three months” and I was out the door.

About 10 years ago I was in a major depression. I have borderline ADHD and my psychiatrist was worried about “amping me up” on Wellbutrin. So she put me on all kinds of things to “balance the uplift” from the anti depressants.

One of them was Geodon, an atypical antipsychotic. Problem: I’ve never had symptoms of psychosis. But it says something about how depressed I was that I didn’t challenge her pharmaceutical tinkering . . . until the Geodon had me spinning in circles from the panic it induced. I had to take Ativan to calm me down until it wore off.

A psychologist friend got me in with a much better psychiatrist, who set me up for CBT with a very good therapist, and took me off everything but the Wellbutrin. A year later I was off everything and have been fine ever since.

Depression is a b****. I hope you’ve got a good therapist. I don’t think medication works without therapy. But I’m probably biased.

Yeah, polypharmacy seems to be really rife in psychiatry. One thing I do like about my current shrink is that he’s pretty conservative when it comes to adding meds or upping dosages or whatever. He even took me off of the antipsychotic I’m on, although he said “Keep some on hand and start taking it again if you start getting psychotic” and I just felt like bwaaahahaha, how am I supposed to know if I’m delusional? Like, dude, you’re a shrink, I think you’re supposed to know about anosognosia and the fact that I have a history of it; it’s in my records.

One of them was Geodon, an atypical antipsychotic. Problem: I’ve never had symptoms of psychosis. But it says something about how depressed I was that I didn’t challenge her pharmaceutical tinkering . . . until the Geodon had me spinning in circles from the panic it induced. I had to take Ativan to calm me down until it wore off.

I’ve been on Geodon before; my shrink back in Michigan started me on when I was batsh!t crazy back in the winter of 2015-2016 and I tolerated it pretty well. It also seemed to help eventually (once I actually started taking it properly.)

But then, in the psych ward this summer they had me on more than one antipsychotic; I was on risperidol for a while at one point, then one of the better shrinks took me off of both Geodon and the Risperdal and prescribed Abilify. Ugh… I was on other stuff, too. Lamictal seems to work okay, and I was on it before I was in the psych ward this summer… but then they tried to make me take Lithium anyway (redundant) and I was like “yeah, sorry, hell no,” b/c I have tiny veins and blood draws are difficult and painful to the point of being practically traumatic.

And re: Ativan; I was doped up on benzos a lot of the time too, to make me “calm down” or something, because I would obsessively pace and couldn’t sit still. (This summer, that is. When I was manic I would get combative.) Aaaaand I still have a boatload of Ambien, which is (I’ve been told) related to benzos, but not one itself, from last summer when I couldn’t sleep at all. I might start using it again. It’s really pretty great (short term) except it makes you a little groggy in the morning.

So yep, meds, been there, done that. I should go get a degree in psychopharmacology or something, I’m like halfway there.

(Oh, and yes, I have an excellent therapist. I took an assessment yesterday and it turns out I have barely sub-clinical PTSD (I’ve been diagnosed with it before, actually) and she wants me to do a structured 12 week therapy thingy to help with it.)

Panacea: You can build a trusting relationship in 10 minutes, but you better have mad communication skills to do it.

Yup. The two best doctors I’ve had were urgent care doctors. First time was for Bell’s Palsy, second time was for stitches. In both cases I was in and out in a half hour or so and much calmer than I was before.
Both times, the doctors explained to me exactly what I had to do, and in one case, the doctor got me kicked upstairs to neurology the next morning, just to make sure I did in fact have Bell’s Palsy, because it’s really rare in the under-30 population.

Mark Thorsen: I’m not sure Adams knows anything about communication. He’s cheerfully alienated about half or more of his potential audience, and he hasn’t been funny in years. All Adams and Trump know to do is shout at people until they either agree or go away.
Adams should also just give up the whole cartoonist gig already. He’s just taking up space in the paper that could go to someone more talented and who isn’t a scuzzbucket.

So, the good brand is basically a tax on insufferable stuck up rich twits. Unfortunately the tax is being collected by an exceedingly insufferable rich twit. Maybe we can drop her off in Palmyra to imbibe some ancient Syrian wisdom.

I liked the article and found it interesting, although I had a hard time parsing one of the paragraphs.

I was definitely dangerous for the entire time of every time I was hospitalized, in at least one way. (When I was manic I couldn’t care for myself (ask my friends in Michigan) and when I was super depressed I was definitely acutely suicidal.)

The slightly bitter and annoyed (if that’s the word) psychiatric patient in me still resents being court ordered to be in the psych ward for so long last summer (over a month, with a few days in between the hospitalizations when I was talking blatantly about killing myself to friends – I had lied and faked my way out of the psych ward after a couple of weeks.) But I was certainly dangerous in the legal/psychiatric sense of the word. Hell, I still wanted to kill myself when they eventually let me out and sent me to the group home; my provider (“Dr. Joseph”) said as much as “nobody doubts that you’re suicidal.” But my favorite psychiatrist there (Dr. Muse, he was from somewhere in Latin America and a lovely person) convinced the “treatment team” that locking me up in the Eastern State Hospital for months would do more harm than good, delusional or not.

So a “short stay” was not a problem in that particular episode. (It was, though, during my manic episodes; I would pretend to sleep and pretend to be better to get let out – because I hate being locked up – and I remember when St. Joe’s let me out and I was still messed up, my friend Eugene (who was more or less my guardian at that time and place) was furious.)

Lord, I miss my psychiatrist from back in Michigan. I mean, we still keep in close touch – we are both very attached to each other*, I guess – but I wish he were my treating psychiatrist. He’s brilliant, he’s kinds, he listens, and he actually cares about people. I remember how guilty he seemed to feel about having me involuntarily admitted to St. Joe’s – “I think you’ve been traumatized by that whole experience.” “Well, I’m pretty f*cking resilient,” I said, and ran off to another city.

*Plus his undergrad degree is in English literature from UC Berkeley and he likes Frank Herbert’s Dune; what more can you ask for?

I remember once, in a rather promiscuous manic phase, I mentioned to him that I had spent the night with a very nice young man who was originally from Alaska. “Oh, we just stayed up all night talking and smoking and I played Tom Waits,” I said. (There was rather more to it than that.**) “Be careful with Tom Waits,” he said. “He can lead to dangerous things… like marriage.” *meaningful look.*

** I did learn pretty much his whole history that night, for example, though I won’t divulge it here. Among other things.

Alain: great article. Thanks for sharing it. The author hit several nails on the head.

When I was still working ER in California, we had a number of MH patients who were frequent fliers for 5150’s–mental health holds. They’d come in suicidal, obviously unable to care for themselves, we’d keep them up to 12 hours trying to find an inpatient bed, and in about 24-48 hours after we sent them out, it would be lather rinse repeat.

The psych facilities were so over loaded these patients were being kept less than 24 hours in many cases.

Until we’re willing to stop viewing mental illness as a character flaw, and to fund and treat it appropriately, we’re going to continue playing round robin with people who could be helped . . . and some of them will die because of that.

Panacea:
Until we’re willing to stop viewing mental illness as a character flaw, and to fund and treat it appropriately, we’re going to continue playing round robin with people who could be helped . . . and some of them will die because of that.

I think one of the major problems is that right now ANY health problem is treated as a character flaw. Mental health is just an extra flaw for people to judge you for. At this point, I’m out and out lying about my depression and ADD on intake forms so as to not lose my insurance. It’d be nice to not have to worry about stuff like that, but apparently health care makes Jesus sad. Or something.

PGP: Agreed. My aunt died because my grandmother viewed schizophrenia as a character flaw, and didn’t tell anyone that my aunt had visited the cliff she threw herself from 2 days before she killed herself. Grandma always tried to pretend my aunt wasn’t sick. Sadly, my aunt confided in her, and Grandma didn’t act because to act was to admit there was something wrong.

Polly – you are right about some of the problems in medicine, and I am sorry for your experience.

Are you in the USA? In Australia, anyone presenting to their GP complaining of feeling tired gets basic bloods including thyroid function, it’s really inexcusable for such a common condition to take so long to be diagnosed – and it sounds like your presentation was pretty textbook.

As a female GP, I do find that people just expect that I will spend time listening to them, in a way they don’t expect of men. And I have had female patients who I have referred to (male) specialists only to have their real problems dismissed as ‘anxiety’. I avenge these women by in future referring only the most painful of patients to those specialists.

It is part of why NP clinics are more attractive, but the same part is what makes sCAM practitioners more attractive, and neither are the answer. While NPs are obviously trained in real medicine, they aren’t doctors and don’t have the depth of understanding of the same topics. In Australia, trials of NP clinics to take pressure off EDs have actually had the opposite effect, costing more and seeing an increase in ED attendances referred by the NP clinic.

I’m not saying I know what the answer is, but it seems to me that giving health consumers the time and the environment in which to be heard and to feel heard (by an appropriately qualified person) is a big part of it.

GPG, Panacea, you reminded me how, back in the day when I was 19 and ended up hospitalised after a suicide attempt, my parents’ only worry was what would people say. If they expressed some concern, it was in a rather accusatory way, as in What did you do to us.

There are so many facets of mental illnesses and their sufferers not being taken seriously. I got all colours of Tough it out and It’s just in your head. I got my pneumonia or GERD described as It’s just nerves, get some more meds for your anxiety or learn to relax more. I had a shrink who apparently didn’t believe that someone with depression and anxiety can manage one’s own life and started planning for me when I should get pregnant.

It’s true that the art of persuasion is a separate thing from the art of reasoned argument, as the related skill of rhetoric. The problem is that some messages lend themselves well to rhetoric and others do not. Good messages for rhetoric are simple, appeal to common knowledge, and appeal to common emotions. So telling people that crime is out of control (common emotion/ common knowledge) and that immigrants are to blame (simple/ common emotion) works well rhetorically. Saying that despite public perception crime is generally down, and despite anecdotal evidence immigrants commit fewer crimes per capita, is complex, goes against what people think they know, and thus is not persuasive.

Same thing with healthcare: complex, counter-intuitive and thus not persuasive: problems persist in healthcare because it is a big, complicated system that is hard to fix, Obamacare was necessarily jury-rigged and hobbled by political compromise, and could not fix everything, and any solution in healthcare will hurt some people even if it helps most; nonetheless, this far this has benefitted more people than it has harmed, and could be improved through gradual alteration.

Simple, persuasive argument: problems persist because Obamacare sucks, and removing it will solve those problems.

Now we’re seeing what happens when somebody gets elected on the power of persuasion rather than reason: getting rid of Obamacare without a new solution would be a catastrophe, and coming up with a good alternative is complicated messy work that nobody is even trying to do. It’s like we’ve gone on a date with a serial killer because we liked his shiny car.

More importantly: hagfish are practically the only thing keeping some fishing communities going. They are used for food, research, and making “eelskin” wallets. The fishermen I spoke to know them as “slime eels.”

Psalmanazzar: Now we’re seeing what happens when somebody gets elected on the power of persuasion rather than reason: getting rid of Obamacare without a new solution would be a catastrophe, and coming up with a good alternative is complicated messy work that nobody is even trying to do. It’s like we’ve gone on a date with a serial killer because we liked his shiny car.

There are a lot of factors, I think. First of all, we have a substantial amount of the population that is allergic to facts (most of Kansas, just about every state south of the Mason Dixon line). Secondly, people hate every facet of health care. They hate doctors (too educated and snobby), vaccines, and exercise and nutrition. Finally, people really like being racist and sexist, and the virus can spread really easily to even unlikely people. It doesn’t help that Trump appeals to the serial killer in everyone.
Speaking of unlikely people, I’m no longer talking to one of my uncles because he started spouting anti-Democrat conspiracy theories last summer. And this was a guy who worked in the Peace Corps, hated Scott Walker like poison, and previously liked fishing and parks.
I can only conclude that either living in a fact-free state in a small town finally got to him, or he’s actually secretly hated women and minorities all his life. I’d think it was Alzheimer’s, but that doesn’t run in that side of the family.